1. Field of the Invention
The present invention relates to computer-based telemedicine systems and, more particularly, to an internet-based system to assist clinicians in the screening, diagnosis, treatment and management of glaucoma patients.
2. Description of the Background
Telemedicine systems are playing a larger role in our health care delivery system, largely in response to the demands of the market and governmental policies. This is because telemedicine has potential benefits for all parties inclusive of providers, payors and patients.
One such potential benefit is the ready access to patient medical records. Currently, this is impossible because each set of records reside at a fixed geographical location. Some providers still maintain paper records, while others rely on an electronic medical database of non-distributed (or local) design. Physicians or staff enter text information into a computer program, which then stores the data on a local or remote server that is maintained by a variety of competing vendors or the care facility itself. There is a clear need for a distributed medical database (inclusive of the method for uniform creation, accessing and updating thereof). This is especially true in the franchise setting where numerous provider franchises may be located around the world. It would be greatly advantageous in this context to provide a distributed medical information database system that allows all medical information to remain online and retrievable across geographical bounds. This would facilitate continuity of care and better medical management. Relatively few efforts have been made in this regard.
U.S. Pat. No. 5,170,362 to Greenberg et al. shows a distributed system for subjecting people such as crewmen to computer evaluations and for diagnosing their performance.
U.S. Pat. No. 5,558,638 to Evers et al. shows a comprehensive patient monitor and support system for a plurality of patients located at remote sites. At each patient site, there is a base unit, which can be connected to a number of sensors and/or recorders with sensors. The sensors are for monitoring the patient""s medical state and the recorders are for recording the medical data. The base unit stores the data and transfers the data to a care center, where the data is stored and analyzed. The data retrieved from the base units is accessible on a local area network and care providers of the patients may monitor their patients by accessing the local area network.
U.S. Pat. No. 5,146,562 to Kukla shows a Patient care communication system with a plurality of communication terminals operatively coupled together for the transmission and receipt of messages.
While the above-described medical databases are xe2x80x9cdistributedxe2x80x9d, they are all centered on a single distributed network. They are not a wide area network file system capable of accommodating many franchisee networks.
Another significant advantage of telemedicine lies in improved accuracy of the examination and diagnosis procedure. Computer-guided menu-driven medical examination and diagnostic menus tend to guide clinicians through the right examination procedure and to the right diagnosis. Again, a few efforts have been made in this regard. For instance, U.S. Pat. No. 6,003,020 shows an intelligent profiling system, and U.S. Pat. No. 5,551,436 shows a medical diagnosis system which compares input data from a physician consultation to reference ranges to generate an evaluation report. Both the ""436 and ""020 patents suggest form-driven guided interviews. U.S. Pat. No. 5,746,204 to Schauss shows a disease analysis system which compares a database of disease symptoms to actual patient symptoms to generate a diagnosis.
U.S. Pat. No. 5,910,107 to Iliff shows a computerized medical diagnostic and treatment method for providing computerized, knowledge-based medical diagnostic and treatment advice. U.S. Pat. No. 5,437,278 to Wilk shows a medical diagnosis system that measures physical parameters of a patient (inclusive of scan images) and actually provides a diagnosis.
All of the above systems provide symptom-based diagnosis or support in the context of an expert system. There is one disease that is known as xe2x80x9csymptom freexe2x80x9d that would elude the prior art. Glaucoma affects approximately 2% of the population under 65 years of age and 11% over 65, and it is exceedingly difficult to diagnose and define. There is a great need for a system capable of assisting in the management, diagnosis and treatment of glaucoma. Presently, glaucoma makes up 20% of all ophthalmology business, and optometrists have been recently legislated to manage glaucoma. On the other hand, glaucoma treatment has been burdened by decreased reimbursement, and this has lead to difficulties in keeping dedicated practices current with new equipment and technologies. It would be greatly advantageous to provide a new technology in the form of a distributed system dedicated to the care and management of glaucoma. To date, there have been no known efforts to develop an internet-based system to assist clinicians in the screening, diagnosis, treatment and management in the treatment of glaucoma patients. A few computer systems offer actual patient color testing. For example, U.S. Pat. No. 5,539,482 to James et al. shows a computer glaucoma diagnostic test using visual color-pattern stimuli. However, this system is geared for direct presentation to the patient and does not assist the clinician or attending doctor in collecting information or comparing results.
It would be greatly advantageous to provide a comprehensive web-based application that is geared for use by clinicians and technicians in administering to glaucoma patients in a geographically-distributed setting. Preferably, the web application would include a guided examination and diagnosis engine incorporating a menu-driven form-based interview for guiding the technician through a patient examination, and a comparative analysis stage with images of symptoms for helping the technician to diagnose glaucoma-related problems.
In accordance with the above, it is an object of the present invention to provide an integrated software and hardware solution that uses the Internet to provide telemedical direct perimetry and ophthalmoscopy to support optometric providers in the screening, diagnosis, treatment and management of glaucoma patients.
It is another object to provide a comprehensive web-based application that is geared for use by clinicians and technicians in administering to glaucoma patients, and including a guided examination and diagnosis engine incorporating a menu-driven form-based interview for guiding the technician through a patient examination, and a comparative analysis stage with images of symptoms for helping the technician to diagnose glaucoma-related problems.
It is another object to take a glaucoma-oriented approach to both the interview and comparative analysis to ensure accurate and reliable diagnosis and prescription for the symptom free disease.
It is another object to provide timely, comprehensive glaucoma test reporting under the oversight of a renowned glaucoma specialist, such that attending clinicians can receive direction on when to refer, and how to manage care longer term
In accordance with the above-described object, the present invention provides an internet-based glaucoma screening and diagnostic system to assist clinicians in the screening, diagnosis, treatment and management of glaucoma patients. The glaucoma screening and diagnostic system employs a business model designed to manage glaucoma through the following four distinct phases:
1. Data collectionxe2x80x94an internet-based data submission module customized with computer-guided menu-driven medical examination menus to guide clinicians through the right examination procedure. This includes a distributed database with all necessary fields/history/testing requirements for glaucoma.
2. Data interpretationxe2x80x94a comparative data analysis module customized with computer-guided menu-driven medical diagnostic menus to guide clinicians to the right diagnosis based on a comparative analysis with visual fields and disk images, and inclusive of a comprehensive on-line library of authoritative references.
3. Results Reportingxe2x80x94Automated and customized report generation achieving or exceeding standard of care/best practices for glaucoma diagnosis, treatment and analysis.
4. Disease Managementxe2x80x94An entirely new approach to glaucoma care based on a prioritized disease management model.
All four of the foregoing capabilities are integrated by the present invention into a comprehensive web-based application that is geared for use by clinicians and technicians in administering to glaucoma patients in a geographically-distributed setting.